1700126240 NPI number — BUILDING FOUNDATIONS COUNSELING CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700126240 NPI number — BUILDING FOUNDATIONS COUNSELING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUILDING FOUNDATIONS COUNSELING CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700126240
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
193 BLUE RAVINE RD
Provider Second Line Business Mailing Address:
SUITE #220
Provider Business Mailing Address City Name:
FOLSOM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95630-4756
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-988-5531
Provider Business Mailing Address Fax Number:
916-987-9749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
193 BLUE RAVINE RD
Provider Second Line Business Practice Location Address:
SUITE #220
Provider Business Practice Location Address City Name:
FOLSOM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95630-4756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-988-5531
Provider Business Practice Location Address Fax Number:
916-987-9749
Provider Enumeration Date:
02/20/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MELL
Authorized Official First Name:
SUZANNE
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
EXECUTIVE DIRECTOR/OWNER
Authorized Official Telephone Number:
916-988-5531

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MFC 35315 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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